The purpose of this three-year study is to determine if Montessori-based activities programming is an effective intervention for older adults with dementia and their caregivers in three types of care settings, including adult day care, assisted living facilities and nursing homes. The proposed study will expand a demonstration project conducted at the Menorah Park Center for Senior Living and extend it to other facilities in the Cleveland area. Outcomes for the older adults with dementia will include frequency and quality of engagement (i.e., active involvement with the social and physical environment), measures of mental health, functional status, and quality of life. Outcomes for the staff caregivers will include measures of perceived caregiver burden, satisfaction, and mastery. Montessori-based activities programming will be compared to other types of novel activities in the control condition. Data will be gathered in two phases. Results from the first phase will be used to modify and improve the intervention for the second phase. In each phase, two sites (facilities) within each type of setting (adult day care, assisted living, nursing home) will take part in the study. One site within each type of setting will be the experimental condition and the other will be the control. Sampling will be conducted such that 25 participants with dementia in each site will finish the study. This will provide a total sample of N = 300 participants (25 per site X 2 sites per setting X 3 settings X 2 phases of the study). The study, therefore, has the following specific aims: 1) to determine if Montessori-based activities programming is an effective intervention for persons with dementia, in comparison to other types of activities in the control condition; 2) to create training materials and procedures that will allow site staff to implement the program effectively; 3) to determine if and to what extent outcomes are differentially affected by settings and sites; 4) to determine effects of programming on care giving staff; and 5) to obtain effect size estimates that can be used for power analyses to prepare for full-scale randomized effectiveness trials.